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NUR 231 M. Johnston, RN-BC, M.Ed. Cindy Irwin, RNC, MN.
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Fetal Monitoring Basics Expanded NUR 231 M. Johnston, RN-BC, M.Ed. Cindy Irwin , RNC, MN
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Transcript of NUR 231 M. Johnston, RN-BC, M.Ed. Cindy Irwin, RNC, MN.
- Slide 1
- NUR 231 M. Johnston, RN-BC, M.Ed. Cindy Irwin, RNC, MN
- Slide 2
- Types of Monitoring Auscultation- listen to fetal heart rate (FHR) Electronic Fetal Monitoring use of instruments to record FHR and uterine contractions(U/Cs)
- Slide 3
- Auscultation Doppler - ultrasound converts sounds waves to signals of fetal heart Fetoscope - Like stethoscope, open end pressed on abdomen, used less frequently
- Slide 4
- Electronic Fetal Monitoring Measures response of FHR to uterine contractions (U/Cs) Intermittent or Continuous External Ultrasound transducer Tocotransducer Internal Fetal Scalp Electrode Intrauterine Pressure Catheter
- Slide 5
- Fetal Monitoring Setup
- Slide 6
- Fetal Heart Rate Characteristics Evaluate to determine fetal status NICHD terminology Baseline Rate Baseline Variability Accelerations (present or absent) Decelerations (present or absent) Changes or trends over time
- Slide 7
- Baseline (BL) Normal range 110-160 bpm Measure between U/Cs for at least 2 min. period during 10 minute segment Tachycardia - >160 bpm for >10 minutes Bradycardia - 10 minutes
- Slide 8
- Baseline
- Slide 9
- Classifications of FHR Variability Fluctuations in FHR, irregular in frequency and amplitude Absent 0-2 bpm Minimal >2 25 bpm
- Slide 10
- Absent Variabilty
- Slide 11
- Minimal Variability
- Slide 12
- Moderate Variability
- Slide 13
- Marked Variability
- Slide 14
- Periodic/Episodic Changes Periodic with uterine contractions Episodic without uterine contractions
- Slide 15
- Accelerations Abrupt increase in FHR above BL Present or Absent < 32 wks gestation Peak 10 bpm above BL for at least 10 sec. >32 wks gestation Peak 15 bpm above BL for at least 15 sec. Accel 10 min. is defined as BL change
- Slide 16
- Accelerations Abrupt increase in FHR above BL Peak 15 bpm above BL for at least 15 sec.
- Slide 17
- Recognition Criteria for Fetal Heart Rate Accelerations Transient increase in the Fetal Heart Rate > 32 weeks acceleration stays 15 beats above the baseline for at least 15 seconds < 32 weeks acceleration stays 10 beats above the baseline for at least 10 seconds
- Slide 18
- Types of Decelerations Early Gradual decrease and return to BL, mirrors the U/C Variable Abrupt (